Simple structured discussions and word games beneficial for people with dementia

Activities as simple as structured discussion groups and word games can benefit memory and thinking for people with Alzheimer’s or dementia, according to a systematic review lead by Professor Bob Woods, of the Dementia Services Development Centre Wales, Bangor University. The review also found that well-being also improved as a result.

The research was published in the Cochrane Systematic Reviews and funded by the National Institute for Health Research. These bring together research on the effects of health care and are considered the gold standard for determining the relative effectiveness of different interventions.

There is a general belief that activities that stimulate the mind help to slow its decline in people with dementia. These activities are termed cognitive stimulation. Cognitive Stimulation involves providing people with dementia with activities intended to stimulate thinking, memory and social interaction, in order to delay the worsening of dementia symptoms. In 2011, the World Alzheimer’s Report recommended that cognitive stimulation should be routinely offered to people with early stage dementia. However, increased interest in its use in dementia in recent years has provoked concern about its effectiveness and potential negative effects on well-being.

The review, published in The Cochrane Library, looked at the results of 15 randomised controlled trials from around the world involving 718 people with mild to moderate dementia, mainly in the form of Alzheimer’s disease or vascular dementia. Participants were treated in small groups and involved in different activities, from discussions and word games to music and baking. All activities were designed to stimulate thinking and memory. Improvements were weighed against those seen without treatment, with “standard treatments”, which could include medicine, day care or visits from community mental health workers, or in some cases alternative activities such as watching TV and physical therapy.

“The most striking findings in this review are those related to the positive effects of cognitive stimulation on performance in cognitive tests,” said lead author, Bob Woods. “These findings are perhaps the most consistent yet for psychological interventions in people with dementia.”

Those who received cognitive stimulation interventions scored significantly higher in cognitive function tests, which measure improvements in memory and thinking. These benefits were still being seen one to three months after treatment. In addition, positive effects on social interaction, communication and quality of life or well-being were observed in a smaller number of the trials, based on self-reported or carer-reported measures.

In one trial, family members were trained to deliver cognitive stimulation on a one-to-one basis, with no additional strain on burden on caregivers reported.

“Involving family caregivers in the delivery of cognitive stimulation is an interesting development and deserving of further attention,” said Woods. “We are beginning a major trial of this approach jointly with University College London in the next few months which will recruit people with dementia and carers across North Wales”.